Strategic Model of Mental Health Nurse Competence and Caregiver in Preventing Relapse Risk in Schizophrenia Patients

M. Suhron; Sitti Sulaihah; Faisal Amir

doi:10.30994/jnp.v9i2.998

Authors

M. Suhron Universitas Noor Huda Mustofa https://orcid.org/0000-0002-9213-7199
Sitti Sulaihah Universitas Noor Huda Mustofa https://orcid.org/0000-0002-6779-1308
Faisal Amir Universitas Noor Huda Mustofa

DOI:

https://doi.org/10.30994/jnp.v9i2.998

Keywords:

caregiver, competence, nurse, preventive, relapse risk, schizophrenia

Abstract

Background: The competences under consideration include clinical knowledge, clinical skills, communication competence, crisis and safety management, professional growth, management of care, and recommendations.

Purpose: Analyzing the Strategic Model of Mental Health Nurse Competence and Caregiver in Preventing Relapse Risk in Schizophrenia Patients.

Methods: The study used a quantitative design with a cross-sectional methodology and included 110 participants, including nurses and caregivers from five community health clinics in East Java Province. The data were obtained using a Likert-scale instrument that was previously validated and reliable. The data was analyzed using the Structural Equation Modeling (SEM) approach using the SmartPLS tool.

Results: All competency characteristics of psychiatric nurses and caregivers have a substantial and essential relationship to the prevention of relapse risk in schizophrenia patients, with a very high model commitment in producing variations in variables which are dependent variables. Conclusion: Thoroughly enhancing the competence of psychiatric nurses and caregivers is an effective method for lowering relapse rates among schizophrenia patients. Suggestions include enhancing the psychiatric nurse education curriculum, providing competency-based continuing training, and incorporating collaborative care models into health care organizations.

Downloads

Download data is not yet available.

References

Abu Sabra, M. A., Hamaideh, S. H., & Hamdan-Mansour, A. M. (2022). Testing Efficacy of Relapse Prevention Intervention among Patients Diagnosed with Schizophrenia in Jordan. Issues in Mental Health Nursing, 43(7), 670–682. https://doi.org/10.1080/01612840.2022.2025634.

Abu Sabra, M. A., & Hamdan-Mansour, A. M. (2022). Using Relapse Prevention Interventions to Maintain Remission and Minimize Relapse Rates for Individuals With Schizophrenia: A Scoping Review. Journal of Psychosocial Nursing and Mental Health Services, 60(7), 47–54. https://doi.org/10.3928/02793695-20220112-02.

Arai, H., Ng, C. G., Siew, W. H., & Abousheishaa, A. A. (2025). Schizophrenia and cancer: Insights into psychiatric nursing care. Archives of Psychiatric Nursing, 54, 102–109. https://doi.org/10.1016/j.apnu.2025.01.006.

Bighelli, I., Rodolico, A., García-Mieres, H., Pitschel-Walz, G., Hansen, W.-P., Schneider-Thoma, J., Siafis, S., Wu, H., Wang, D., Salanti, G., Furukawa, T. A., Barbui, C., & Leucht, S. (2021). Psychosocial and psychological interventions for relapse prevention in schizophrenia: a systematic review and network meta-analysis. The Lancet Psychiatry, 8(11), 969–980. https://doi.org/10.1016/S2215-0366(21)00243-1.

Brand, B. A., Sommer, I. E., Gangadin, S. S., Tanskanen, A., Tiihonen, J., & Taipale, H. (2024). Real-World Effectiveness of Menopausal Hormone Therapy in Preventing Relapse in Women With Schizophrenia or Schizoaffective Disorder. American Journal of Psychiatry, 181(10), 893–900. https://doi.org/10.1176/appi.ajp.20230850.

Chen, J., El-Den, S., Pham, L., O’Reilly, C. L., & Collins, J. C. (2023). Healthcare professionals’ knowledge, confidence and attitudes in relation to psychosis care: A systematic review. International Journal of Social Psychiatry, 69(8), 1856–1868. https://doi.org/10.1177/00207640231194490.

Creswell, J. W., & Creswell, J. D. (2017). Research design: Qualitative, quantitative, and mixed methods approaches (pp. 123–126). SAGE Publications Ltd.

Cuijpers, P., Javed, A., & Bhui, K. (2023). The WHO World Mental Health Report: a call for action. The British Journal of Psychiatry, 222(6), 227–229. https://doi.org/10.1192/bjp.2023.9.

Demarais, M., Fisher, M., Williams-Wengerd, A., Alexandre, C., Meyer-Kalos, P., & Vinogradov, S. (2024). Impact of family engagement on client participation in coordinated specialty care for first episodes of psychosis. BMC Psychiatry, 24(1), 686. https://doi.org/10.1186/s12888-024-06126-y.

Dijkstra, L. G., Weiss, H. A., Birhane, R., Medhin, G., de Silva, M., Hanlon, C., Fekadu, A., & Asher, L. (2025). Effects of community-based rehabilitation on caregivers of people with schizophrenia in Ethiopia in the RISE trial. BMC Psychiatry, 25(1), 231. https://doi.org/10.1186/s12888-025-06651-4.

Fagiolini, A., Leopold, K., Pappa, S., Cottam, W. J., Hickey, J., Rogerson, O., Yildirim, M., & Beckham, C. (2025). Survey on the Initiation of Aripiprazole Once-Monthly via a Two-Injection Start in Adult Patients with Schizophrenia: Experience of European Healthcare Professionals. Advances in Therapy, 42(4), 1935–1949. https://doi.org/10.1007/s12325-025-03130-w.

Gramaglia, C., Gambaro, E., Bestagini, L., Bassi, E., Molin, A. D., & Zeppegno, P. (2025). Nurse-led psychoeducational interventions in patients suffering from schizophrenia or other psychotic disorders and their families: A scoping review protocol. PLOS One, 20(7), e0327486. https://doi.org/10.1371/journal.pone.0327486.

Gumley, A. I., Bradstreet, S., Ainsworth, J., Allan, S., Alvarez-Jimenez, M., Aucott, L., Birchwood, M., Briggs, A., Bucci, S., Cotton, S. M., Engel, L., French, P., Lederman, R., Lewis, S., Machin, M., MacLennan, G., McLeod, H., McMeekin, N., Mihalopoulos, C., … Gleeson, J. (2022). The EMPOWER blended digital intervention for relapse prevention in schizophrenia: a feasibility cluster randomised controlled trial in Scotland and Australia. The Lancet Psychiatry, 9(6), 477–486. https://doi.org/10.1016/S2215-0366(22)00103-1.

Hyatt, A., Mullin, B., Hasler, V., Madore, D., Progovac, A. M., Cook, B. L., & DeLisi, L. E. (2024). Predictors of relapse and engagement in care one year after ending services in an urban safety net coordinated specialty care program for first episode psychosis. Schizophrenia Research, 264, 140–146. https://doi.org/10.1016/j.schres.2023.12.022.

Imkome, E. (2025). Psychometric Evaluation of the Thai Version of the Burdened Caregiver Scale for Schizophrenia and Co-occurring Methamphetamine Use: A Pilot Study. F1000Research, 10, 484. https://doi.org/10.12688/f1000research.52288.4.

Intharit, J., Kittiwattanagul, K., Chaveepojnkamjorn, W., & Tudpor, K. (2021). Risk and protective factors of relapse in patients with first-episode schizophrenia from perspectives of health professionals: a qualitative study in northeastern Thailand. F1000Research, 10, 499. https://doi.org/10.12688/f1000research.53317.1.

Iswanti, D. I., Nursalam, N., Fitryasari, R., Sarfika, R., & Saifudin, I. M. M. Y. (2024). Effectiveness of an Integrative Empowerment Intervention for Families on Caring and Prevention of Relapse in Schizophrenia Patients. SAGE Open Nursing, 10. https://doi.org/10.1177/23779608241231000.

Kumari, S., Joseph, J., & Singh, B. (2023). Nurse-led brief psycho-education on self-stigma among clients with schizophrenia and affective disorders: - Solomon four-group design. Applied Nursing Research, 69, 151657. https://doi.org/10.1016/j.apnr.2022.151657.

Liu, W.-I., Hsieh, W.-L., Lai, C.-T., Liu, C.-C., Tai, Y.-M., & Liu, C.-Y. (2024). Effectiveness of a needs-tailored nurse-led recovery program for community-dwelling people with schizophrenia: a cluster-randomized controlled trial. BMC Nursing, 23(1), 329. https://doi.org/10.1186/s12912-024-01986-x.

Luconi, F., Montoro, R., Lalla, L., & Teferra, M. (2022). An Innovative Needs Assessment Approach to Develop Relevant Continuing Professional Development for Psychiatrists. Academic Psychiatry, 46(1), 106–113. https://doi.org/10.1007/s40596-021-01564-2.

Maramis, M. M., Sofyan Almahdy, M., Atika, A., Bagus Jaya Lesmana, C., & Gerick Pantouw, J. (2022). The biopsychosocial-spiritual factors influencing relapse of patients with schizophrenia. International Journal of Social Psychiatry, 68(8), 1824–1833. https://doi.org/10.1177/00207640211065678.

Moncrieff, J., Pillai, E., Marston, L., Lewis, G., Barnes, T. R. E., Johnson, S., & Priebe, S. (2025). The association between relapse and the outcome of schizophrenia and recurrent psychotic disorders. The British Journal of Psychiatry, 227(4), 673–679. https://doi.org/10.1192/bjp.2024.304.

Ostuzzi, G., Bertolini, F., Tedeschi, F., Vita, G., Brambilla, P., del Fabro, L., Gastaldon, C., Papola, D., Purgato, M., Nosari, G., Del Giovane, C., Correll, C. U., & Barbui, C. (2022). Oral and long‐acting antipsychotics for relapse prevention in schizophrenia‐spectrum disorders: a network meta‐analysis of 92 randomized trials including 22,645 participants. World Psychiatry, 21(2), 295–307. https://doi.org/10.1002/wps.20972.

Putri, S. B., Suwito, T. bin, Panduragan, S. L., Esti, A., Martin, W., Welly, & Ulya, R. (2025). Recovery Nursing Care to Prevent Relapse Among Schizophrenia Patients: A Systematic Review. Malaysian Journal of Medicine and Health Sciences, 21(May), 167–174. https://doi.org/10.47836/mjmhs.21.s3.26.

Rantala, M. J., Luoto, S., Borráz-León, J. I., & Krams, I. (2022). Schizophrenia: The new etiological synthesis. Neuroscience & Biobehavioral Reviews, 142, 104894. https://doi.org/10.1016/j.neubiorev.2022.104894.

Renwick, L., Susanti, H., Brooks, H., Keliat, B., Bradshaw, T., Bee, P., & Lovell, K. (2023). Culturally adapted family intervention for people with schizophrenia in Indonesia (FUSION): a development and feasibility study protocol. Pilot and Feasibility Studies, 9(1), 53. https://doi.org/10.1186/s40814-023-01280-8.

Solmi, M., Seitidis, G., Mavridis, D., Correll, C. U., Dragioti, E., Guimond, S., Tuominen, L., Dargél, A., Carvalho, A. F., Fornaro, M., Maes, M., Monaco, F., Song, M., Il Shin, J., & Cortese, S. (2023). Incidence, prevalence, and global burden of schizophrenia - data, with critical appraisal, from the Global Burden of Disease (GBD) 2019. Molecular Psychiatry, 28(12), 5319–5327. https://doi.org/10.1038/s41380-023-02138-4.

Song, J., Zhang, Y., Qin, M., Ren, J., Jia, Y., Yu, H., & Zhou, Y. (2024). Experiences of returning to work in patients with schizophrenia after treatment: A longitudinal qualitative study. International Journal of Social Psychiatry, 70(3), 588–600. https://doi.org/10.1177/00207640231223423.

Suhron, M. (2024). Public Health Epidemiology Research Book (DR M. Suhron S.Kep.,Ns. (ed.); 1st ed.). SABDA EDU PRESS. https://scholar.google.co.id/scholar?hl=id&as_sdt=0,5&cluster=14372596901005326170.

Susanti, H., Brooks, H., Keliat, B., Bradshaw, T., Wulandari, D., Fadilah, R., Diorarta, R., Suherman, Bee, P., Lovell, K., & Renwick, L. (2024). Stakeholder perspectives of family interventions for schizophrenia in Indonesia: a qualitative study. BMC Psychiatry, 24(1), 59. https://doi.org/10.1186/s12888-024-05504-w.

Takeda, T., Umehara, H., Matsumoto, Y., Yoshida, T., Nakataki, M., & Numata, S. (2024). Schizophrenia and cognitive dysfunction. The Journal of Medical Investigation, 71(3.4), 205–209. https://doi.org/10.2152/jmi.71.205.

Thongsalab, J., Yunibhand, J., & Uthis, P. (2023). Recovery-oriented nursing service for people with schizophrenia in the community: An integrative review. Belitung Nursing Journal, 9(3), 198–208. https://doi.org/10.33546/bnj.2632.

Van Leeuwen, E., van Driel, M. L., Horowitz, M. A., Kendrick, T., Donald, M., De Sutter, A. I., Robertson, L., & Christiaens, T. (2021). Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults. Cochrane Database of Systematic Reviews, 2021(4). https://doi.org/10.1002/14651858.CD013495.pub2.

Yu, H., Sun, Y., Qin, M., Ren, J., Yu, K., Song, J., Zhou, Y., & Liu, L. (2023). Perception of risk of relapse among patients with first episode and recurrent schizophrenia: a descriptive phenomenological study. BMC Psychiatry, 23(1), 582. https://doi.org/10.1186/s12888-023-05023-0.

Zayts-Spence, O., Edmonds, D., & Fortune, Z. (2023). Mental Health, Discourse and Stigma. BMC Psychology, 11(1), 180. https://doi.org/10.1186/s40359-023-01210-6.

Zhu, E., Wang, J., Zhou, G., Li, C., Chen, F., Ju, K., Chen, L., Yin, Y., Chen, Y., Zhang, Y., Zhang, X., Zhou, X., Wang, Z., Qiu, J., Wang, H., Shi, W., Wang, F., Wang, D., Chen, Z., … Ai, Z. (2025). A highly scalable deep learning language model for common risks prediction among psychiatric inpatients. BMC Medicine, 23(1), 308. https://doi.org/10.1186/s12916-025-04150-7.

Zlatintsi, A., Filntisis, P. P., Garoufis, C., Efthymiou, N., Maragos, P., Menychtas, A., Maglogiannis, I., Tsanakas, P., Sounapoglou, T., Kalisperakis, E., Karantinos, T., Lazaridi, M., Garyfalli, V., Mantas, A., Mantonakis, L., & Smyrnis, N. (2022). E-Prevention: Advanced Support System for Monitoring and Relapse Prevention in Patients with Psychotic Disorders Analyzing Long-Term Multimodal Data from Wearables and Video Captures. Sensors, 22(19), 7544. https://doi.org/10.3390/s22197544.

Zukowska, Z., Allan, S., Eisner, E., Ling, L., & Gumley, A. (2022). Fear of relapse in schizophrenia: a mixed-methods systematic review. Social Psychiatry and Psychiatric Epidemiology, 57(7), 1305–1318. https://doi.org/10.1007/s00127-022-02220-2.